RC-11-793_
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
nspection Number: INSP - 165694
Permit Number: RC -5 -11 -793
Inspection Date: October 20, 2011
Inspector. Bruhn, Norman
Owner: CRUZ, ISAIAS
Job Address: 9817 N MIAMI Avenue
Miami Shores, FL 33150-
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132060131100
Building Department Comments
RETILE BATHROOM WALLS AND SHOWER AREA
Passe/If
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
October 21, 2011
For Inspections please call: (305)762 -4949
Page 1 of 1
FERNANDO GOMEZ -PINA P.E.
CONSULTING ENGINEER
250 IrATALONIA AVE, # 404
CORAL GABLES, FL 33134
TEL: (305) 461 -21 88
FAX: (305) 461-2238
AS BUILT CERTIFICATE
September 29, 2011
Miami Shores Village
Building Department
10050 NE 2nd Avenue
Miami Shores, Florida 33138
Re: Enclosure for Isaias Cruz
9817 N. Miami Avenue
Miami Shores, Florida 33150
Permit N2: RC -5 -11 -793
Dear Sirs:
I hereby attest that, the structure is structurally sound and the work satisfies the
requirements of the Code in effect on this date, January 2009. My statement is based on the
following detailed, methodology procedure:
REPAIR WORK AT EXISTING BATHROOM:
SLABS: N /A, Existing.
PARTITION FRAMING: Opened wall to verify size and spacing of studs; 2" x 4" @ 16" o/c
anchored to a 2 x 4 P.T. at bottom.
INSULATION: Opened drywall to verify R — 5 insulation at exterior wall.
a
DRYWALL: Opened drywall to verify; %2" waterproof w /screws at 12" o/c all around.
Fernando Gomez -Pina # 14710 (Name)
250 Catalonia Avenue, # 404, Coral Gables, Florida 33134 (Address)
305- 461 -2188 (Telephone)
S)IO,,bI Onn
51«-ts
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
Permit 1 e: BUILDIN _ ! -! ING
Phon Z Q't' '�' #73
/
MAY 0 4 2011
Permit No.
Master Permit No. 12C. t
Tenant/Lessee Name:
Email:
JOB ADDRESS:
State: y474 Zip:
Phone #:
4). ,'2i67n1,
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: ,e4.) Phone #:
Address:
City: State: Zip:
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer:
Phone#:
Value of Work for this Permit: $ ! Square/Linear Footage of Work:
Type of Work: UAddition
Description of Work:
DNew ORepair/Replace
ODemolition
** **** *+ x*+ x** ***********a:*a:********** *** Fees* **** ****+ r***+ x* **** ************+x********* **
Submittal Fee $ Permit Fee $ t(b7 ° CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
No . Training/Education Fee $ Technology Fee $
��ov
� Structural Review $
TOTAL FEE NOW DUE $
/awe
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which o urs . days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approve; a , / a reinspection fee will be charged.
Signatu� 1 , , Signature
Owner or Agent
The foregoin • instrument was ackn
day of / / ' 20//, isy
who is . rso 4i ly known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
,,a X84., ,, .r Sib,• Sign: .`„� ..0Q1tes•''`
10612012 •.
?UM _ Print:
E. NOi��Y = My Commission Expires:
•. Commiss S ion # :.
+x*+x***** ***+x******u:*+x******* *04 1 * .*** x�x�x: �x* a��x�u�x+ x+ x�x* x��x�: �x* x��xx��x�x�x+ x***** �xx��x�x�x +��:�x�xx��x**** *******
APPROVED BY ���� Plans Examiner Zoning
Structural Review Clerk
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 _, by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
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Miami Shores dl ge
APPROVED
ZONING DEPT
BLDG DEPT
SURIlCT To COMPLIANCE WITH
STATE AND COUNTY RULES AND
Q• l l —'7q
;-/iett z-e,/
FEDERAL
GULATIONS
FEB ViVit
15 2011
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